This part focuses on SSRI physical side effects otherwise known as ADRs (Adverse Drug Reactions). Whilst some short term side effects are addressed by Health and Social Care practitioners, the relatively unknown and serious physical side effects researched from epidemiology are addressed in this part.

Research shows there is a link between antidepressants and individual variations in the polymorphic region of the Serotonin Transporter Gene and CYP450 2D6, 2C19 and 2C9 variations with outcomes of psychosis, mania, akathisia, suicide, homicide and insomnia.

In 2016 The Medicines and Healthcare products Regulatory Agency (MHRA) stated all SSRI product literature contains the potential warnings of suicide and related behaviour, such as aggression, nightmares, agitation, hallucinations, mania, panic attacks and akakthisia. Excluded from the SSRI product literature are:peculiar body sensations, bizarre thinking and reasoning, psychosis,and homicide/homicidal ideation. Every behaviour stated above is due to SSRI toxicity. Since the MHRA takes no responsibility of ensuring other regulatory bodies are kept up to date, many sites used by Health and Social Care pratitioners are currently inaccurate. This is not satisfactory. Further more the MHRA do not reveal SSRI and pharmacogentic variations affect outcome, which I think is misleading as the product literature implies psychological side effects is all a hot and miss affair. This is not correct as specific gentic variations are linked to worsoning mental health conditions and could be avoided by genotype testing.

Regardless of whether antidepressants are prescribed for a mental health disorder or for pain relief in physical diseases, antidepressant medications do cause dependency and may cause physical, cognitive and psychological side effects if individuals are not able to break down drugs efficiently.

The intensity of the withdrawal effects are determined by patients' genetic makeup; patients who are Poor Metabolisers of SSRIs will experience greater withdrawal effects compared with patients who are Extensive Metabolisers who are able to metabolise antidepressants efficiently. This explains why some patients withdraw from antidepressants without any difficulty.